Minstrell, M and Bentley, M and Bucher, H and Morrisey, M and Higgs, C and Robinson, A and Stirling, C, Open referral policy within a nurse-led memory clinic: patient demographics, assessment scores, and diagnostic profiles, International Psychogeriatrics, 27, (6) pp. 967-979. ISSN 1041-6102 (2014) [Refereed Article]
Copyright 2014 Springer
Background: Memory clinics, typically led by multidisciplinary teams and requiring health professional referral, are one means of providing diagnosis and care coordination for dementia. Nurse-led clinics may provide an effective and alternative means to dementia diagnosis, and open referral policies may minimize existing barriers to accessing a diagnosis, but evidence is needed.
Methods: Patients attending a one-day per week nurse-led memory clinic over a 25-month period during 2011–2013 (n = 106) completed comprehensive cognitive assessments and were diagnosed by an aged care nurse practitioner. Descriptive statistics detail the demographics, assessment scores, and diagnostic profiles of patients. Comparable data from published literature was identified, and the differences were analyzed qualitatively.
Results: One hundred and six patients were assessed with the key differences from other data sets being history of falls more common, higher mean Mini-Mental State Examination scores, and fewer dementia diagnoses. Sixty-four patients (60%) were self-referred to the nurse-led memory clinic, of which 19 (30%) were diagnosed with mild cognitive impairment (MCI) or dementia. Overall, forty-eight patients (45%) received diagnoses of MCI or dementia.
Conclusions: An open referral policy led to a high proportion of patients being self-referred, and nearly a third of these were diagnosed with cognitive impairment or dementia. Open referral policies and nurse-led services may overcome some of the barriers to early diagnosis that are currently experienced. Considering an aging population worldwide and the associated increases in cognitive impairment, which benefits from early identification and intervention, this paper provides an alternative model of nurse-led assessment.
|Item Type:||Refereed Article|
|Keywords:||memory clinic, nurse practitioner, open referral policy, nurse-led clinic, self-referral, dementia|
|Research Division:||Health Sciences|
|Research Group:||Health services and systems|
|Research Field:||Aged health care|
|Objective Group:||Provision of health and support services|
|UTAS Author:||Minstrell, M (Dr Melinda Minstrell)|
|UTAS Author:||Bentley, M (Dr Michael Bentley)|
|UTAS Author:||Higgs, C (Mr Carl Higgs)|
|UTAS Author:||Robinson, A (Professor Andrew Robinson)|
|UTAS Author:||Stirling, C (Professor Christine Stirling)|
|Web of Science® Times Cited:||6|
|Deposited By:||Wicking Dementia Research and Education Centre|
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